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2019 CMS Web Interface Quality Reporting for MIPS Groups and ACOs CMS Web Interface Support Call January 22, 2020
2019 CMS Web Interface Quality Reporting for MIPS Groups and ACOs
CMS Web Interface Support Call
January 22, 2020
Disclaimer
This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes frequently, so links to the source documents have been provided within the document for your reference.
This presentation was prepared as a service to the public and is not intended to grant rights or impose obligations. This presentation may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents.
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Announcements
• CMS Web Interface Submission Period (January 2, 2020 - March 31, 2020)
- Submission Period
• The submission period for the CMS Web Interface will align with other submission types, and closes promptly at 8:00pm Eastern Daylight Time (EDT) on March 31, 2020.
• The CMS Web Interface will not have a Test Period prior to the start of the submission period. Now, the CMS Web Interface submission period is longer and spans a three-month timeframe.
• The CMS Web Interface will automatically accept your submission at the end of the submission period.
• The CMS Web Interface is Accessible via the “Sign In” link on the Quality Payment Program website at https://qpp.cms.gov.
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CMS Web Interface Key Dates
Announcements
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Upcoming CMS Web Interface Support Calls
• Weekly Support Calls
- Please note: All weekly support calls listed below will be held on Wednesdays from 1:00pm to 2:00pm EST/*EDT.
• For more information on the support calls and links to register, review the 2019 CMS Web Interface Support Calls flyer.
• If you encounter any registration issues or audio issues during a support call, please send an e-mail to [email protected].
January 29, 2020 March 4, 2020
February 5, 2020 March 11, 2020*
February 12, 2020 March 18, 2020*
February 19, 2020 March 25, 2020*
February 26, 2020
Reminders
• Other CMS Approved Reason skip requests must be submitted through the CMS Web Interface.
- A CMS Approved Reason is a way to skip a patient attributed to a measure during Denominator Confirmation.
• Reserved for circumstances that are unique, unusual, and not covered by any of the denominator exclusions or denominator exceptions identified in the measure specifications.
• Patients for whom a CMS Approved Reason is selected will be “skipped” and another patient must be reported in their place for the measure, if available.
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Reminders
• 2019 CMS Web Interface Application Programming Interface (API) is available all year for testing in the Developer Preview Environment:
- For more information, please review:
• CMS Web Interface API Narrative Documents: https://cmsgov.github.io/beneficiary-reporting-api-docs/
• Swagger Documents: https://preview.qpp.cms.gov/api/submissions/web-interface/docs/
• Measures.json: https://preview.qpp.cms.gov/api/submissions/web-interface/metadata
• Schema.json: https://preview.qpp.cms.gov/api/submissions/web-interface/metadata/schema
• Google Group for the CMS Web Interface API: https://groups.google.com/forum/#!forum/cms-web-interface
• Beginning February 1, this Google Group will no longer be accessible. Please visit qpp.cms.gov for information regarding Quality Payment Program requirements.
• For any support related issues, please contact the Quality Payment Program at [email protected].
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ASSIGNMENT & SAMPLING FAQsPresenter: Kara Sokol, CMS Contractor
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Assignment & Sampling FAQ
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No. Question Answer
1 What if prepopulated demographic information is not accurate?
While the CMS Web Interface user can modify the demographic information that is prepopulated into the CMS Web Interface from the Medicare beneficiary enrollment database, it is anticipated that there will be little need for ACOs, MIPS groups, and virtual groups to modify this information. However, if the beneficiary’s demographic information in your records and in the CMS Web Interface does not match, then the CMS Web Interface user may need to correct the information. For example, Medicare claims may not have the accurate date of birth for a beneficiary. Your ACO, MIPS group, or virtual group should correct this information because it may affect that beneficiary’s denominator eligibility for certain measures. Note that any demographic information you changed in the CMS Web Interface does not get reported back to the Medicare beneficiary enrollment database. You should encourage your patient to contact the Social Security Administration directly to have such information updated.
PREV-12 SCORING UPDATEPresenter: Lisa Marie Gomez, CMS
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PREV-12 Scoring Update
• The following scoring changes will be applied to PREV-12 (Preventative Care and Screening: Screening for Depression and Follow-Up Plan) for the 2019 performance year:- For the Medicare Shared Savings Program and Next Generation ACO Model, the measure is
changing from pay-for-performance to pay-for-reporting.
- For purposes of MIPS, the measure will be excluded from scoring.
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FREQUENTLY ASKED MEASURE QUESTIONS
Presenter: Angela Stevenson, CMS Contractor
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DM-2: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
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No. Question Answer
1 If we have a lab result that shows a collection date and a result date, (e.g., collection date is 11/1/19 and result date is 11-5-19), which date would we use to report the result in order for the measure to be compliant?
Based on the measure specification, it is appropriate to provide the date the blood was drawn.
Use the following priority ranking:• Lab report draw date• Lab report date• Flow sheet documentation• Practitioner notes• Other documentation
HTN-2: Controlling High Blood Pressure
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No. Question Answer
1 Are blood pressure readings from an Inpatient setting, emergency department, or urgent care acceptable?
Yes. Although the measure is intended to be outpatient, blood pressure readings from any clinical setting are acceptable when reporting the numerator for the 2019 HTN-2 measure. It would be appropriate to move to the next most recent blood pressure in the measurement period if the most recent is from an Inpatient or Emergency Department visit and is not within normal parameters.
If a blood pressure reading from an Urgent Care setting is the most recent in the measurement period, it should be used. Urgent Care codes are included in the Encounter Codes within the HTN Coding Document. Blood pressure readings taken at those outpatient visits should be included.
2 Does the blood pressure reading have to be from the most recent visit in the measurement year?
No. Performance is based on the most recent blood pressure documented in the patients medical record during the measurement period. The most recent blood pressure may or may not be found within the most recent visit.
PREV-7: Preventive Care and Screening: Influenza Immunization
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No. Question Answer
1 The code 90689 - Influenza virus vaccine quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25mL dosage, for intramuscular use code was new 10-1-18 and not included in the 2019 PREV Coding document. Is this vaccine acceptable to meet the measure?
IIV4 vaccines are not excluded in the measure specifications. The Numerator Codes in the 2019 PREV Coding Document are all inclusive for the purpose of mapping from the EHR but If medical record documentation shows the patient received an IIV during the appropriate time frame it is acceptable.
2 2019 Influenza Immunization spec still states LAIV vaccinations as not eligible for the numerator. The CDC approved the LAIV vaccination for the 2018-2019 flu season. Given the fact that the CDC approved this vaccination again, will these immunizations be considered numerator compliant for the 2019 reporting year?
Per CMS direction, if a patient receives the live attenuated influenza vaccine for the 2018-2019 flu season, you should report a Denominator Exception - System Reasons.
PREV-7: Preventive Care and Screening: Influenza Immunization
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No. Question Answer
3 Does there need to be documentation that the patient met denominator exception criteria during the flu season (August 1, 2018 -March 31, 2019)?
For 2019, documentation should be during the measurement period and be specific to the flu season being reported unless the selection is for documentation of a medical reason for not receiving the influenza vaccination due to an egg allergy. A documented history of an egg allergy in the patient’s medical record is acceptable for this exception.
Beginning in 2020, documentation of an egg allergy must be during the measurement period and be specific to the flu season being reported to ensure the allergy is still active. A documented history of an egg allergy in the patient’s medical record will no longer be accepted. This guidance aligns with the measure steward’s intent for using the Denominator Exception: Medical Reason.
PREV-10: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
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No. Question Answer
1 Does a screening done in the Emergency Department (ED) or Inpatient count?
Yes. The setting is not specified for this measure. You must use the encounter where the most recent tobacco user status was documented.
2 What if the patient is screened and is a smoker, but is screened again at a later date and is considered a non-smoker?
If there is more than one patient query regarding tobacco use, use the most recent during the 24-month look-back period from the measurement period end date (1/1/2018 -12/31/2019). In this scenario, the patient would be considered a non-smoker for purposes of the measure.
3 Is there a specific length of time that a patient has to be a non-smoker for them to be considered not a current tobacco user?
No. There is no specified length of time that must pass after a patient ceases using tobacco in which they may be considered a non-smoker.
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No. Question Answer
4 What medications are acceptable for tobacco cessation?
The Numerator Drug Codes in the 2019 PREV Coding Document may be referenced for a listing of appropriate medications. These codes are considered all inclusive for the purpose of EHR mapping; however, medical record documentation can be used to determine if the patient meets the intent of the measure. Both the brand name and generic versions of the drugs in the coding document are acceptable.
5 Who is able to complete the cessation intervention within our organization (e.g., can a Medical Assistant provide counseling to the patients or does it need to be a physician)?
Cessation counseling can be provided by anyone your organization considers qualified and for whom the eligible clinician or group takes responsibility for.
Per the measure specifications, in order to promote a team-based approach to patient care, the tobacco cessation intervention can be performed by another healthcare provider; therefore, the tobacco use screening and tobacco cessation intervention do not need to be performed by the same provider or clinician.
PREV-10: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
RESOURCES & WHERE TO GO FOR HELPPresenter: Lisa Marie Gomez, CMS
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Resources
• 2019 QPP Resource Library
- Website: https://qpp.cms.gov/about/resource-library
- 2019 MIPS Quality Performance Category
- 2019 CMS Web Interface Fact Sheet
- 2019 CMS Web Interface Measure Specifications and Supporting Documents
- 2019 CMS Web Interface Sampling Methodology
- 2019 CMS Web Interface & CAHPS for MIPS Survey Assignment Methodology
- 2019 CMS Web Interface Excel Template
- 2019 CMS Web Interface Excel Template with Sample Data
- 2019 CMS Web Interface Data Dictionary
- 2019 CMS Web Interface User Guide
- 2019 CMS Web Interface FAQs
- 2019 CMS Web Interface User Demo Videos (Playlist)
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Resources
• 2019 QPP Webinar Library
- Website: https://qpp.cms.gov/about/webinars
- 2019 CMS Web Interface User Demonstration (Recorded 11/13/2019)
• Recording, Slides, Transcript
- CMS Web Interface Kick Off Call (Recorded 12/11/2019)
• Recording, Slides, Transcript
• QPP Help and Support
- Website: https://qpp.cms.gov/about/help-and-support
- Materials: Videos, support calls, online courses, learning network, APM learning systems, and developer tools
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Resources
• Medicare Shared Savings Program ACO:
- Website: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/
- Quality Measures & Reporting Standards: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Quality-Measures-Standards.html
- Weekly ACO Spotlight Newsletter
• Next Generation ACO Model:- Website: https://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/
- Connect Site: https://app.innovation.cms.gov/NGACOConnect/
- Weekly Newsletter
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Medicare Shared Savings Program and Next Generation ACOs
Get Help from CMS
• Quality Payment Program:
- E-mail: [email protected]
- Phone: 1-866-288-8292 (TTY: 1-877-715-6222)
• Medicare Shared Savings Program ACO:
- E-mail: [email protected]
• Next Generation ACO Model:
- E-mail: [email protected]
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Help Us Improve the Quality Payment Program Experience!
We’re looking for participants to collaborate with us and provide feedback regarding the Quality Payment Program website (qpp.cms.gov), including the following:
The QPP Research Teams invite you to participate in our Human-Centered Design efforts.
Interested in participating?Email your name, title, topic of interest, and organization to:
Our research sessions range from 30-60 minutes and you can join by phone or webinar.
• Educational Materials• Website Content • Website Design
• Reporting Design• Eligibility Content Layout• Performance Feedback Layout
Question and Answer Session
To ask a question over the phone line, please raise your hand and we
will unmute your line.
For those dialed in via phone, you must have your unique audio pin entered. If you’re listening through your
computer speakers and want to ask a question, you must have a working microphone.
You may also submit questions via the Questions tab for speakers to read aloud.
Speakers will address as many questions/comments as time allows.
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Get Help from CMS
• Quality Payment Program:
- E-mail: [email protected]
- Phone: 1-866-288-8292 (TTY: 1-877-715-6222)
• Medicare Shared Savings Program ACO:
- E-mail: [email protected]
• Next Generation ACO Model:
- E-mail: [email protected]
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